2024 Conservation Ambassador Program Application Form
Thank you for your interest in the NRCA Conservation Ambassador Program (CAP). We are delighted that you're applying!

Gracias por su interés en el Programa de Embajadores de la Conservación (CAP) de la NRCA. Le animamos a que se postule en el programa hoySi necesita este formulario en español, envíe un correo electrónico a laura.cisneros@uconn.edu.

Who Can Apply (Quién Puede Postular):
Any high school student that is currently in grades 8, 9, 10, or 11 that is interested enjoying the outdoors this summer and contributing to local environmental action.

Cualquier estudiante de secundaria de 8º, 9º, 10º u 11º curso que esté interesado en disfrutar del aire libre este verano y contribuir a la acción medioambiental en su comunidad.

Application (Solicitud):
Applications should be prepared by the student (parents, guardians or teachers should not submit an application on behalf of the student). If you would like to prepare your application in a Word or Google Document, you can find a version here.

Las solicitudes deben ser preparadas por el estudiante (los padres, tutores o profesores no deben presentar una solicitud en nombre del estudiante). Si desea preparar su solicitud en un documento de Word o Google, puede encontrar una versión aquí.

Please submit your completed application by May 6, 2024. You will be emailed about your CAP admission decision by May 13, 2024 (we will email you using the email address provided below; make sure to check your email).

Envíe su solicitud completa antes del 6 de mayo de 2024. Se le enviará un correo electrónico sobre su decisión de admisión antes del 13 de mayo de 2024 (le enviaremos un correo electrónico utilizando la dirección de correo electrónico proporcionada a continuación; asegúrese de revisar su correo electrónico).

Important Dates (Fechas Importantes):
  • May 6 - Application Due (please complete this online form by this date) -- Fecha de Solicitud (complete este formulario en línea antes de esta fecha)
  • May 13 - Applicants Notified of CAP Admission Decision (email sent to your email used in this application) -- Notificación a los Solicitantes de la Decisión de Admisión al CAP (correo electrónico enviado a su dirección de correo electrónico utilizada en esta solicitud)
  • June 3 - Enrollment Forms Due (forms mailed to your address used in this application) -- Vencimientos de Inscripción (formularios enviados por correo a la dirección utilizada en esta solicitud)
  • July 14-20 - Summer Field Experience (overnight camp at UConn) -- Campamento de Verano en UConn (alojarse en los dormitorios de la UConn)
  • August 2024-March 2025 - Environmental Action Project (carried out in your community and at your pace; tailored to your interests and community need; you receive support from an undergrad Difference Maker Mentor and community partner) -- Acción Ambiental en su Comunidad (usa sus nuevas habilidades en un proyecto ambiental que beneficie a su comunidad; obtenga apoyo de un mentor universitario de UConn y un miembro adulto de la comunidad)
  • April 2025 - Project Showcase (at UConn or CT Science Center) -- Presentación del Proyecto (en UConn o CT Science Center)

Need Help? (¿Necesita Ayuda?)
If you have any questions, please feel free to contact the NRCA Director, Laura Cisneros, at laura.cisneros@uconn.edu or visit our Frequently Asked Questions section on our website at https://nrca.uconn.edu/cap/#faq.

Si tiene alguna pregunta, no dude en ponerse en contacto con la Directora de la NRCA, Laura Cisneros, en laura.cisneros@uconn.edu o visite nuestra sección de Preguntas frecuentes en nuestro sitio web en https://nrca.uconn.edu/cap/#faq. Laura habla español, si prefiere comunicarse en español.

A copy of this form will be sent to the email address you provide below.
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Email *
Student Information
At the NRCA, we believe that our communities thrive when everybody has access to and feels welcome in local greenspaces and that community members of all ages and backgrounds bring innovative ideas, assets, and solutions to address local environmental issues. We strive to create programs and services that represent the full diversity of the Connecticut community. We are asking the following questions to ensure that we are meeting this goal. The confidentiality of your information will be maintained by NRCA faculty and staff. All electronic files will be password protected.
Student's First Name *
Student's Last Name *
What do you prefer to be called? *
Student's Birth Date (month/day/year) *
Student's Current Age *
Student's School Name *
Student's Current Grade *
Student's Graduation Year *
Home Mailing Address (needed for program packets) *
City *
State (abbreviation) *
Zip *
Student's Phone Number *
What type of phone? *
Student's Email Address (needed for admission decisions) *
Student's T-Shirt Size *
Student's Dietary or Other Medical Restrictions *
With regard to gender, which of the following best describes you?  (select all that apply)   *
If you selected "Prefer to self-describe", you are welcome to use this space to describe your gender.
Student's Pronouns *
If you selected "Prefer to self-describe", you are welcome to use this space to describe your pronouns.
You will be staying in the dorms with a roommate during the summer field experience. Do you have a preference for the gender of your roommate(s)?  (select all that apply) *
With regard to race or ethnicity, which of the following best describes you?  (select all that apply)   *
If you selected "Prefer to self-describe", you are welcome to use this space to describe your race and/or ethnicity.
If you decide to attend college, will you be the first generation? (select one) *
We invite you to share any of your identities that are important to you (e.g., religion, cultural heritage, other affinity groups). (optional)
Parent/Guardian Information
Please provide the following information for one guardian of the applicant.
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Relationship to Student *
Parent/Guardian's Phone *
What type of phone? *
Parent/Guardian's Email Address *
Adult Recommender Information
Please provide the following information for one adult recommender (e.g., educator, coach, counselor, mentor, current or former employer, etc.).
Recommender's First Name *
Recommender's Last Name *
Recommender's School or Organization Name (list where they work or the organization they are affiliated with) *
Recommender's Email Address *
How do you know the recommender? *
Student Application Questions
Please answer each of the questions below to the best of your ability. This is your time to shine!
1. Why are you interested in participating in the NRCA Conservation Ambassador Program (CAP)? (note: keep responses between 50-150 words) *
2. Describe an activity that you initiated or participated in that made a positive impact on your class, school, or community. Please provide specific examples.  (note: keep responses between 50-150 words) *
3. The goal of CAP is to support you as an environmental changemaker in your community. Why is being a community changemaker important to you? (note: keep responses between 50-150 words) *
4a. Check the topics/activities that interest you (select all that apply):
Yes, this interests me
Alternative Energy Sources
Climate Change
Cultural History
Environmental Activism
Food, Nutrient, & Health
Gardening or Agriculture
Habitat Restoration
Invasive Species
Local Government
Map Making
Nature Connectedness & Wellness
Public Speaking
River and Park Clean-Ups
Social Justice
Soil Science
Tech: App Design, Coding, Gaming, Web Design, Etc.
Traditional Ecological Knowledge
Water Quality
Wildlife Watching/Tracking
4b. If you checked "Other" above, please list some other topics/activities that interest you.
5. How did you hear about the NRCA Conservation Ambassador Program? (select all that apply) *
Would the student prefer to receive the enrollment materials in Spanish or English?
Would the guardian prefer to receive the enrollment materials in Spanish or English?
CAP Fee: Free or Sliding Scale Statement
It is our goal to make the Conservation Ambassador Program (CAP) available to all students regardless of financial circumstances. Thanks to generous funding sources, the cost of CAP ranges from no cost to a reduced fee.

No Cost: CAP is free to...
(1) students attending a qualifying school (i.e., Title 1 schools or schools with >50% of the student population qualifying for free/reduced lunch; check if your school qualifies here: https://nces.ed.gov/ccd/schoolsearch/)
(2) students who qualify for free/reduced lunch themselves


Reduced Fee:
For students who do not meet the above requirements, CAP program fees are determined by a sliding scale that takes into account annual household income and the number of claimed dependents. Additional financial assistance may also be provided on a case by case basis. See the sliding fee scale below:
No-Cost Qualification *
I attend a qualifying school (i.e., Title 1 school or school with >50% of the student population qualifying for free/reduced lunch)
I qualify for free/reduced lunch
Environmental Action Project Stipends
Thanks to a Giving Day campaign, we are able to provide need-based stipends to a subset of students! This means you could get paid as you work on your environmental action projects. These stipends will be awarded based on financial need.
Stipend Interest *
If accepted into CAP, I would like to apply for/be considered for the Environmental Action Project Stipend
Thank you for your interest in the NRCA Conservation Ambassador Program. By submitting this application form, the parent/guardian and student understand, acknowledge, and agree with the following disclosures and requirements:
Parent/Guardian Consent *
I hereby submit an application for my child to attend the 2023-24 NRCA Conservation Ambassador Program.
If accepted, I understand an enrollment packet will be mailed to the address I provided above, and I will need to complete the Enrollment Forms by June 4th to hold a spot for my child in the program.
A copy of your responses will be emailed to the address you provided.
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